Successful thrombus extraction with the Rescue thrombus management system during acute percutaneous coronary intervention improves flow but does not necessarily restore optimal myocardial tissue perfusion.

Full Abstract

We determined the effectiveness of the Rescue device in restoring flow and achieving optimal tissue perfusion during percutaneous coronary intervention (PCI) in thrombus-laden coronary arteries.

METHODS:
A total of 30 patients with an acute coronary syndrome underwent PCI using the Rescue device.

RESULTS:
The mean age was 65.5 +/- 9.8 years. Although the Rescue device could not be passed across the lesion in 6 (20%) cases, debris was aspirated in 26 (87%). The uncorrected TIMI frame count improved following the use of the Rescue device and improved further at the completion of PCI (92.2 +/- 23.9 pre-PCI vs. 38.7 +/- 31.3 post-Rescue vs. 21.96 +/- 24 post-PCI, P < 0.0001). The thrombus score improved from 4 +/- 0 to 2.2 +/- 1.29 to 0.86 +/- 1.4 (P < 0.0001). TIMI flow grade (TFG) 3 was restored in 60% of cases following the Rescue device and in 87% after PCI. Myocardial blush grade 3 occurred in only 13% of patients following the Rescue device and 37% of patients after PCI.

CONCLUSION:
These data suggest that the Rescue device can aspirate considerable amounts of debris in the majority of patients and significantly improves the angiographic epicardial coronary blood flow. How effective such a device is in improving tissue perfusion and, thereby, clinical outcomes for patients remains to be seen.Copyright 2006 Wiley-Liss., Inc.

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Author information

Author/s: Vijayalakshmi, Kunadian (K); Kunadian, Babu (B); Wright, Robert A (RA); Sutton, Andrew G C (AG); Hall, James A (JA); de Belder, Mark A (MA);

Affiliation: Department of Cardiology, the James Cook University Hospital, Middlesbrough, United Kingdom.

Journal and publication information

Publication Type: Clinical Trial; Comparative Study; Journal Article

Journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (Catheter Cardiovasc Interv), published in United States. (Language: eng)

Reference: 2006-Jun; vol 67 (issue 6) : pp 879-86

Dates: Created 2006/05/30; Completed 2006/11/28;

PMID: 16652368, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Aged
Angioplasty, Transluminal, Percutaneous Coronary
Atherectomy, Coronary - methods
Coronary Angiography
Coronary Circulation
Coronary Thrombosis - physiopathology; radiography; therapy
Embolism - prevention & control
Female

Female
Humans
Male
Myocardial Infarction - physiopathology; radiography; therapy
Myocardial Reperfusion
Stents
Treatment Outcome
Vascular Patency

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